Objective: The main objective of this study was to see the various histopathological changes in the gallbladder with cholelithiasis and to correlate them with Helicobacter hepaticus infection. 

Methods: A total of 380 cholecystectomy specimens were received during a study period from 2058/11/29 to 2059/11/4 at Department of Pathology, TU Teaching Hospital, Institute of Medicine. Results: Among 380 cases, 249 (65.53%) were found to have chronic cholecystitis, 52 (13.68%) cholesterolosis, 29 (7.63%) adenomyosis, 20 (5.26%) metaplasia, 15 (3.95%) low-grade dysplasia, 10(2.63%) malignancy, 4(1.05%) xanthogranulomatous change and 1(0.26%) carcinoma in situ. Out of these, 100 cases that were willing to provide gallbladder for study were taken as a study group. Sections were stained with Haematoxylin & Eosin for microscopic features and with Warthin Starry Silver stain for Helicobacter hepaticus. Among the study group, 43% cases were found to have chronic cholecystitis, 17% adenomyosis, 13% cholesterolosis, 9% low-grade dysplasia, 9% metaplasia, 7% malignancy, 1% carcinoma in situ and 1% xanthogranulomatous change. All the malignant cases were found to be Adenocarcinoma. Out of total 100 cases, 82% cases were found to have Helicobacter hepaticus infection. Only one out of 7 malignant cases (14.29%) was found to be negative for Helicobacter Hepaticus infection. Gallbladder neoplasm was found to be common in Nepal comprising 2.63%. Helicobacter hepaticus infection was found in 82% of gallbladders and it was found in 87.5% of malignant cases. Whether Helicobacter hepaticus that might be the number one cause for the gallstone formation that ultimately leads to malignancy or itself acts as a risk factor for the pathogenesis of carcinoma gallbladder is yet to be determined.